Modified Retromandibular Approach for the Management of Condylar Fractures of the Mandible

Bhat, Swetha; Krishna, Vinod K; Periasamy, Senthilnathan; Kumar, Santhosh; Murugesan, K.

doi:10.7759/cureus.27697

Cited by 4 publications

(4 citation statements)

References 16 publications

(18 reference statements)

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“…7,8 These maneuvers would have increased the nerve's transient palsy-causing retractive pressures. According to the literature, the transient facial nerve injury ranges from 12 to 25 percent [9][10][11][12][13][14][15] , our 18% finding is in line with the same. In all of these cases of neurological damage, mecobalamin 1500mg was recommended for 3 weeks (once daily) 16 to help in rehabilitation.…”

Section: Discussionsupporting

confidence: 84%

Study of Facial Nerve Function Following Retromandibular Open Reduction of Mandibular Condylar Fracture

Bhatti,

Mustafa,

Umar

et al. 2023

PJMHS

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At least 1/3rd (26–40%) of all mandibular fractures occur in the condylar region, making it one of the most common fracture sites. They can further lead to morphological & functional damage when undetected or poorly managed. Condylar fractures that are misdiagnosed or improperly treated can cause substantial functional impairment, such as malocclusion, decreased mouth opening due to jaw deviation, and restricted lateral mandibular motions. Objectives: The aim of the study was to examine facial nerve function following retromandibular trans parotid ORIF for mandibular sub-condylar fractures. Methodology: After receiving the necessary ethical approval, 50 patients who presented with unilateral condylar fractures, sub condylar fractures (36), & neck fractures (14) (Ellis classification)5 were chosen. All of the research participants, who underwent open reduction using a retromandibular technique, provided informed consent. Results: All 50 patients were assessed and no patients were excluded. The healing went well, and no one experienced significant scarring or hardware infection. 7 (14%) individuals experienced transient buccal branch weakness, while 2 (4%) experienced transient zygomatic branch dimness Keywords: Condylar fracture, Open reduction, Retromandibular approach, Anatomical reduction

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Section: Discussionsupporting

confidence: 84%

Study of Facial Nerve Function Following Retromandibular Open Reduction of Mandibular Condylar Fracture

Bhatti,

Mustafa,

Umar

et al. 2023

PJMHS

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“…Two incisions of the preauricular approach and submandibular approach are typically required with complications of facial nerve paralysis, scar, and occurrence of the Frey syndrome. 5 The facial nerve paralysis, including both permanent and temporary damage, is mainly due to the preauricular approach. While permanent damage is uncommon, neuropraxia is relatively prevalent.…”

Section: Discussionmentioning

confidence: 99%

“…Sliding vertical ramus osteotomy has several advantages for the reconstruction of the temporomandibular joint, such as avoiding the risk of a free graft and donor site complications, similar shape and histologic characteristics with the condyle, and low cost. Two incisions of the preauricular approach and submandibular approach are typically required with complications of facial nerve paralysis, scar, and occurrence of the Frey syndrome 5 . The facial nerve paralysis, including both permanent and temporary damage, is mainly due to the preauricular approach.…”

Section: Discussionmentioning

confidence: 99%

A Novel Technique for Resection and Reconstruction of the Temporomandibular Joint by Sliding Vertical Ramus Osteotomy using Only Submandibular Approach

Wang

Sun

et al. 2023

Journal of Craniofacial Surgery

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In this paper, an innovative technique for resection and reconstruction of the temporomandibular joint by sliding vertical ramus osteotomy using only a submandibular approach is presented. Before pulling the posterior mandibular border slightly downward to expose parts of the condyle, the vertical ramus osteotomy was performed. With the help of 3D simulation and surgical templates, the condylectomy was carried out using the ultrasonic osteotome through the submandibular approach. Our technique achieved the desired results while preventing complications of facial nerve paralysis, the occurrence of Frey syndrome, and the preauricular scar. Therefore, we suggest that this surgical method represents an alternative treatment option for temporomandibular joint lesions.

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“…It follows the contracting lateral pterygoid muscle, eventually reaching the infratemporal fossa. Currently, there are two main ways to reach the proximal fragment and its anatomical reduction [3][4][5][6][7][8]: preauricular access and retroauricular access. Both are percutaneous accesses and allow the direct visualization of the displaced fragment to the infratemporal region.…”

Section: Introductionmentioning

confidence: 99%

Lateral Pterygoid Muscle Alteration in Patients Treated Surgically Due to Mandibular Head Fractures

Kozakiewicz,

Pruszyńska

2023

JCM

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The goal of surgical treatment of mandibular head fracture is to restore anatomical relations; however, it also carries other implications. The purpose of this study is to present the alteration in the size of lateral pterygoid muscles after surgical treatment of unilateral mandibular head fractures and the impact of this change on the range of motion of the mandible. Another issue addressed is the persistence of changes in the appearance of the lateral pterygoid muscles after surgical treatment. In this study, 66 patients with unilateral mandibular head fracture were included. An additional 15 patients from this group who were treated only conservatively were separated as an extra reference group to exclude completely the effect of surgery on the appearance of the pterygoid lateral muscle (even on the opposite side to the surgically treated side). The range of mandibular movements was measured at specific time intervals up to 24 months post-operationally. Then, the lengths and widths of the lateral pterygoid muscles on the operated and healthy site were measured in CT images. The results were compared with a control group which consisted of muscles of the intact site (opposite site to the fracture). A significant reduction in the length-to-width ratio of the lateral pterygoid muscle on the operated side by approx. 20% is observed. This suggests that the muscle becomes more spherical, and thus the range of lateral movement to the contralateral side is permanently reduced.

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Modified Retromandibular Approach for the Management of Condylar Fractures of the Mandible

Cited by 4 publications

References 16 publications

Study of Facial Nerve Function Following Retromandibular Open Reduction of Mandibular Condylar Fracture

Study of Facial Nerve Function Following Retromandibular Open Reduction of Mandibular Condylar Fracture

A Novel Technique for Resection and Reconstruction of the Temporomandibular Joint by Sliding Vertical Ramus Osteotomy using Only Submandibular Approach

Lateral Pterygoid Muscle Alteration in Patients Treated Surgically Due to Mandibular Head Fractures

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